Incident Report | Customer Accident X | Staff Accident |
Information only | Property damage / loss |
Date Reported: 5/27/98 | Time Reported: 10:50 a.m. |
Nature of Incident: Staple Stuck in carpet in meeting room - child scraped arm on caused bleeding | |
Location: Northside | |
Date Occurred: 5/27/98 | Time Occurred: 10:45 a.m. |
Person Involved: MC | Telephone: 294-xxxx (Kiddie Prep School) |
Address: xxxxxxx | |
Details of Incident: (Who, What, When, Where, Why) | |
M scraped arm on a staple that was stuck in the carpet
in the meeting room. This happened during storytime.
Staple caused M's arm to bleed. Gave M a band-aid.
M's address & phone unknown - with Kiddie Prep School - Teacher said to use their address & phone number |
|
Person Reporting: Stacey Willard | Same as above: |
[Note: names and personal info abbreviated to protect privacy.]